Question 1

Ventilatory measurements routinely monitored at the bedside include all of the following except:

Accepted Answer

A) airway pressures. 
B) lung volumes and flows. 
C) fractional gas concentrations. 
D) oxygen consumption and carbon dioxide production. 
A) airway pressures. 
B) lung volumes and flows. 
C) fractional gas concentrations. 
D) oxygen consumption and carbon dioxide production. D

Question 2

Which of the following ventilator changes will have to be made if the problem of "breath stacking" is to be resolved?

Accepted Answer

A) Increase in tidal volume 
B) Increase in respiratory rate 
C) Increase in inspiratory flow 
D) Increase in both respiratory rate and inspiratory flow 
A) Increase in tidal volume 
B) Increase in respiratory rate 
C) Increase in inspiratory flow 
D) Increase in both respiratory rate and inspiratory flow C

Question 3

Volutrauma is most likely to develop in:

Accepted Answer

A) the larger airways. 
B) dependent lung regions. 
C) nondependent lung regions. 
D) small airways. 
A) the larger airways. 
B) dependent lung regions. 
C) nondependent lung regions. 
D) small airways. C

Question 4

In a sedated, mechanically ventilated patient, inspiratory tidal volumes are consistently larger than expiratory tidal volumes.If it is assumed that there is no leak in the circuit, which of the following provides the best explanation for this discrepancy?

Accepted Answer

A) Ventilator malfunction 
B) The compressibility factor of the ventilator circuit 
C) An increase in airway resistance that causes air trapping 
D) Different pressure profiles 
A) Ventilator malfunction 
B) The compressibility factor of the ventilator circuit 
C) An increase in airway resistance that causes air trapping 
D) Different pressure profiles

Question 5

In healthy, spontaneously breathing patients, an occasional increase in tidal volume to three or four times the normal level, which normally occurs about six to ten times each hour, is the definition of a:

Accepted Answer

A) sigh. 
B) cough. 
C) sneeze. 
D) forced vital capacity. 
A) sigh. 
B) cough. 
C) sneeze. 
D) forced vital capacity.

Question 6

All the following activities are included in respiratory monitoring except:

Accepted Answer

A) alarm setting. 
B) pulmonary consults. 
C) physical examinations. 
D) measurements and calculations. 
A) alarm setting. 
B) pulmonary consults. 
C) physical examinations. 
D) measurements and calculations.

Question 7

When carbon dioxide elimination is monitored, the highest levels are obtained at the:

Accepted Answer

A) end of inhalation. 
B) end of exhalation. 
C) middle of inhalation. 
D) middle of exhalation. 
A) end of inhalation. 
B) end of exhalation. 
C) middle of inhalation. 
D) middle of exhalation.

Question 8

For weaning to be successful, the patient's spontaneous minute ventilation needs to be less than _____ L/min.

Accepted Answer

A) 10 
B) 20 
C) 30 
D) 40 
A) 10 
B) 20 
C) 30 
D) 40

Question 9

It is important to monitor ventilatory parameters in addition to arterial blood gases because:

Accepted Answer

A) it is easier and more cost-effective to monitor ventilatory parameters. 
B) changes in ventilatory parameters will occur before they are seen in arterial blood gases. 
C) monitoring of ventilatory parameters does not require specialized equipment and can be done more quickly. 
D) monitoring of ventilatory parameters can be done without a physician's order, whereas arterial blood gas monitoring requires a physician's order. 
A) it is easier and more cost-effective to monitor ventilatory parameters. 
B) changes in ventilatory parameters will occur before they are seen in arterial blood gases. 
C) monitoring of ventilatory parameters does not require specialized equipment and can be done more quickly. 
D) monitoring of ventilatory parameters can be done without a physician's order, whereas arterial blood gas monitoring requires a physician's order.

Question 10

Which of the following is normally used when PEEP levels are titrated to determine optimal PEEP?

Accepted Answer

A) Flow-time curve 
B) Volume-time curve 
C) Pressure-time curve 
D) Pressure-volume curve 
A) Flow-time curve 
B) Volume-time curve 
C) Pressure-time curve 
D) Pressure-volume curve

Question 11

An important advantage of monitoring mechanical tidal volumes proximally is that:

Accepted Answer

A) it decreases circuit resistance and dead space. 
B) it decreases the respiratory work for the patient. 
C) the measuring device is less susceptible to condensation. 
D) it eliminates the compressible volume factor of tubing circuits. 
A) it decreases circuit resistance and dead space. 
B) it decreases the respiratory work for the patient. 
C) the measuring device is less susceptible to condensation. 
D) it eliminates the compressible volume factor of tubing circuits.

Question 12

The highest incidence of postoperative morbidity is associated with which of the following surgery sites?

Accepted Answer

A) Transsternal 
B) Upper abdominal 
C) Lower abdominal 
D) Thoracoabdominal 
A) Transsternal 
B) Upper abdominal 
C) Lower abdominal 
D) Thoracoabdominal

Question 13

All of the following are likely to increase the mean airway pressure (MAP) except an increase in:

Accepted Answer

A) flow rate. 
B) PEEP levels. 
C) peak pressure. 
D) expiratory time. 
A) flow rate. 
B) PEEP levels. 
C) peak pressure. 
D) expiratory time.

Question 14

All of the following will cause an increase in intrapulmonary shunting except:

Accepted Answer

A) ARDS. 
B) atelectasis. 
C) pneumonia. 
D) cystic fibrosis. 
A) ARDS. 
B) atelectasis. 
C) pneumonia. 
D) cystic fibrosis.

Question 15

The portion of delivered oxygen actually consumed and an index of the efficiency of circulation is the definition for the:

Accepted Answer

A) oxygenation index (OI). 
B) oxygen extraction ratio (C[a - v]O₂/CaO₂). 
C) arterial-mixed venous oxygen content difference (C[a - v]O₂). 
D) arterial-mixed venous oxygen saturation difference (S[a - v]O₂). 
A) oxygenation index (OI). 
B) oxygen extraction ratio (C[a - v]O₂/CaO₂). 
C) arterial-mixed venous oxygen content difference (C[a - v]O₂). 
D) arterial-mixed venous oxygen saturation difference (S[a - v]O₂).

Question 16

Which of the following conditions explains why lung damage persists after recovery from a severe protracted episode of acute respiratory distress syndrome (ARDS)?

Accepted Answer

A) Volutrauma 
B) Severity of the episode of ARDS 
C) Use of excessive amounts of PEEP during the episode 
D) Condition of the lungs before the onset of disease 
A) Volutrauma 
B) Severity of the episode of ARDS 
C) Use of excessive amounts of PEEP during the episode 
D) Condition of the lungs before the onset of disease

Question 17

On the oxygen dissociation curve (ODC), the P-50 refers to the:

Accepted Answer

A) partial pressure of oxygen when the hemoglobin is 50% saturated. 
B) hemoglobin saturation when the fraction of inspired oxygen is 50%. 
C) partial pressure of oxygen when the fraction of inspired oxygen is 50%. 
D) hemoglobin saturation when the partial pressure of oxygen is 50 mm Hg. 
A) partial pressure of oxygen when the hemoglobin is 50% saturated. 
B) hemoglobin saturation when the fraction of inspired oxygen is 50%. 
C) partial pressure of oxygen when the fraction of inspired oxygen is 50%. 
D) hemoglobin saturation when the partial pressure of oxygen is 50 mm Hg.

Question 18

The amount of force needed to overcome opposition to air flow in the lungs during mechanical ventilation is known as:

Accepted Answer

A) peak pressure. 
B) airway pressure. 
C) maximal airway resistance. 
D) positive end-expiratory pressure. 
A) peak pressure. 
B) airway pressure. 
C) maximal airway resistance. 
D) positive end-expiratory pressure.

Question 19

Which of the following conditions is the most common cause of inadequate oxygenation of pulmonary capillary blood?

Accepted Answer

A) Hypovolemia 
B)    mismatch 
C) Hypoventilation 
D) Diffusion defect 
A) Hypovolemia 
B)    mismatch 
C) Hypoventilation 
D) Diffusion defect

Question 20

It is important to monitor lung volumes in ICU patients because changes in lung volumes reflect all of the following changes except:

Accepted Answer

A) changes in gas exchange in the lung. 
B) changes in the patient's clinical status. 
C) a response to therapy and any problems that may arise. 
D) they influence the selection of antibiotic therapy in the ICU. 
A) changes in gas exchange in the lung. 
B) changes in the patient's clinical status. 
C) a response to therapy and any problems that may arise. 
D) they influence the selection of antibiotic therapy in the ICU.

Exam 14: Respiratory Monitoring in Critical Care

Ventilatory measurements routinely monitored at the bedside include all of the following except:

Which of the following ventilator changes will have to be made if the problem of "breath stacking" is to be resolved?

Volutrauma is most likely to develop in:

In a sedated, mechanically ventilated patient, inspiratory tidal volumes are consistently larger than expiratory tidal volumes.If it is assumed that there is no leak in the circuit, which of the following provides the best explanation for this discrepancy?

In healthy, spontaneously breathing patients, an occasional increase in tidal volume to three or four times the normal level, which normally occurs about six to ten times each hour, is the definition of a:

All the following activities are included in respiratory monitoring except:

When carbon dioxide elimination is monitored, the highest levels are obtained at the:

For weaning to be successful, the patient's spontaneous minute ventilation needs to be less than _____ L/min.

It is important to monitor ventilatory parameters in addition to arterial blood gases because:

Which of the following is normally used when PEEP levels are titrated to determine optimal PEEP?

An important advantage of monitoring mechanical tidal volumes proximally is that:

The highest incidence of postoperative morbidity is associated with which of the following surgery sites?

All of the following are likely to increase the mean airway pressure (MAP) except an increase in:

All of the following will cause an increase in intrapulmonary shunting except:

The portion of delivered oxygen actually consumed and an index of the efficiency of circulation is the definition for the:

Which of the following conditions explains why lung damage persists after recovery from a severe protracted episode of acute respiratory distress syndrome (ARDS)?

On the oxygen dissociation curve (ODC), the P-50 refers to the:

The amount of force needed to overcome opposition to air flow in the lungs during mechanical ventilation is known as:

Which of the following conditions is the most common cause of inadequate oxygenation of pulmonary capillary blood?

It is important to monitor lung volumes in ICU patients because changes in lung volumes reflect all of the following changes except:

Preparing for the Patient Encounter

The Medical History and the Interview

Cardiopulmonary Symptoms

Vital Signs

Fundamentals of Physical Examination

Neurologic Assessment

Clinical Laboratory Studies

Interpretation of Blood Gases

Pulmonary Function Testing

Chest Imaging

Interpretation of Electrocardiogram Tracings

Neonatal and Pediatric Assessment

Older Patient Assessment

Vascular Pressure Monitoring

Cardiac Output Measurement

Bronchoscopy

Nutrition Assessment

Sleep and Breathing Assessment

Home Care Patient Assessment

Documentation

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